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General NPI Number Information
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NPI Number | 1376846998
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Entity Type | Organization
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Legal Business Name | MCLEOD PHYSICIAN ASSOCIATES II
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Dates
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Enumeration Date | 12/21/2010
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 401 EAST CHEVES STREET SUITE 201
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City | FLORENCE
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State | SC
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Zip | 29506-2615
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Country | US
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Telephone | 843-777-7951
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Fax | 843-777-7981
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | FLORENCE
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State | SC
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Zip | 29502-3239
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Country | US
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Telephone | 843-667-0816
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Fax | 843-679-5075
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Authorized Official
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Title or Position | SR. VP
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Name | DANE FICCO
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Credential |
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Telephone | 843-777-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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